PELI PAL Cards: A Tool for Communicating Preferences

PAL cards provide an easy tool to exchange information at a glance about a community member’s background and important preferences for daily life. PAL cards briefly profile each community member and highlight their recreation and leisure interests. Organizations that use PAL cards find they promote more personalized care. Also, the cards spark conversations between staff, volunteers, and community members, contributing to a greater sense of connectedness.

This tip sheet provides step-by-step instructions to create PAL cards using a customizable Microsoft Word template. PELI-PAL cards are designed as small (5 by 7 inches) double-sided documents that can be laminated and placed on a wheelchair or walker or attached to a person’s door.

Step 1: Plan And Conduct A PELI-PAL Interview

PAL Cards summarize information collected through interviews conducted with the Preferences for Everyday Living Inventory (PELI). The PELI PAL Card Interview and PAL Card template are available for free download at preferencebasedliving.com. The basic PELI PAL Card interview lists 34 PELI recreation and leisure items. Your organization can decide whether to use all 34 items, select a subset, or add other items from the full PELI. For tips on choosing questions, see PELI Tip Sheet #1: How to Get Started.

Once you have customized your PELI PAL Card interview form, begin interviewing community members. Start by explaining your purpose and asking for consent. For example: “We’d like to create a PAL Card with a brief profile of you and your preferences. If you agree, we will share the card with staff, volunteers and other community members so they can get to know you better.” If possible, show a sample PAL Card.  When conducting an interview, it is best to:

• Strive for a conversational approach.
• Begin by asking about the person’s background – perhaps: “Where are you from? What did you do for a living? Do you have children and grandchildren? What are your best memories about growing up?”
• Take notes on details; ask: “Can you tell me more about that?”
• Highlight items that stand out as very important to the community member.
• For additional suggestions, see PELI Tip Sheet #2: Interview Tips.

Step 2: Review Items That Are Important To The Individual

After the interview, review your notes and identify items that are especially important to the individual; note the items that made the person “light up.” Standout topics or preferences are those that the person talked about and shared easily, and which created a positive emotional response. Highlight this information on the PAL Card so that others can get to know the individual better, understand their preferences, and build relationships.

Step 3: Using The PAL Card Template

• Download the PAL Card template (a Microsoft Word document).
• To create the front of the card, insert the individual’s name on the top left side of the template. On the right side, create a profile that mentions topics such as the person’s birthplace, occupation, family and interests.
• In the bottom section, which forms back of the card, add four to six preferences that are very important to the person – for example, cooking, music, television, outdoors, games and other interests. Be sure to include details obtained during the interview in order to truly personalize the card.
• Save and print the document. Then cut it in half, attach the two sides back-to-back, and laminate if possible.
• Punch a hole in the upper left corner. Tie ribbon or string through the hole so the card can be attached to a wheelchair or walker.    

Step 4: Approving And Attaching The PAL Card

Show the PAL Card to the community member and ask whether it accurately reflects his or her preferences. Make changes as needed. Once the person approves, ask where the card should be placed. PAL Cards on wheelchairs or walkers can travel with the person throughout the community. Another option is to attach the PAL Card to the person’s door. Community members may wish to decorate their PAL Cards, either as an individual or group activity.

Your organization might consider developing a PAL Card policy. Procedures could include:

• Document when a community member agrees to a PAL Card interview and sharing the information in the health record.
• Ask each person to sign and date the card, as well as indicate that it reflects their important preferences. The card could then be scanned and placed in the chart or electronic health record.
• Bring the card to the next care-planning meeting when the family is present. Family also could sign the card.

Step 5: Using PAL Cards

When you are ready to begin using PAL Cards, discuss the purpose with community members, staff, volunteers, and family. Encourage everyone to use the cards as conversation starters as well as to foster a warm, welcoming and engaging community. Consider having care team members create PAL cards to share with the community.

FAQ’s  

What items do I need to complete the PAL card?
You will need the PELI-PAL form with preference items selected from the PELI questionnaire, a printer, laminator (optional), hole punch and either string or ribbon.

What if the resident is unable to communicate?
Ask family or friends to complete the preference questions. For details, see PELI Tip Sheet #3: Working with Proxies.

How frequently should the PAL card be updated?
Our research suggests that preferences generally remain stable for at least three months. We recommend meeting with community members periodically to see if their preferences have shifted. Also, PAL Cards may need to be updated when an individual’s health status changes significantly.

Does the PAL Card comply with HIPAA rules?
It is best not to include medical information on PAL Cards. Medically related data, such as “Risk of Falls,” may be protected health information (PHI). We recommend placing PAL Cards in open view for maximum effectiveness. Each person has the right to opt out of having a PAL Card, and can restrict the information (e.g., religion) displayed on the card.

What if we want to use other items from the PELI?
PAL Cards are a customizable tool. Please feel free to review the full 72-item PELI-NH interview and select the questions most helpful for your PAL Cards and your community.

We wish to recognize Suzanne House and thank the staff and residents of the Knolls of Oxford for helping to develop and pilot test PAL cards.